Two more recent outbreaks discovered in Nevada and New York garnered considerable media attention. In November 2007, reports surfaced that a New York anesthesiologist reused syringes when withdrawing medicine from multi-dose vials. In the process he potentially exposed thousands of patients to blood-borne viruses. On December 14, 2007 the New York Department of Health contacted approximately 8,500 patients exposed by this practice and urged them to be tested for Hepatitis and HIV.

The CDC suggests two possible ways the syringes could have been contaminated.

Backflow from the patient’s intravenous catheter or from needle removal might have contaminated the syringe with HCV (hepatitis C) and subsequently contaminated the vial. Medication remaining in the vial was used to sedate the next patient.

The 2002 Oklahoma outbreak was traced back to a nurse anesthetist supervised by an anesthesiologist at a hospital outpatient clinic. In response the American Association of Nurse Anesthetists (AANA) mailed copies of the AANA Infection Control Guidelines to its members.

The organization also hired a research firm to conduct a random telephone survey of Certified Registered Nurse Anesthetists (CRNAs) and anesthesiologists “to learn more about practices and attitudes on needle and syringe reuse.” A spokesperson termed the finding as “eye opening.”

They were forced to revisit the problem of the reuse because of the events in New York and Nevada. On March 6, 2008, Dr. Wanda Wilson, the AANA President, commented on the sad state of affairs.

It is astounding that in this day and age there are still nurse anesthetists, anesthesiologists and other health professionals who still risk using needles and syringes on more than one patient, or know of such activities and don’t report them. Published standards and guidelines dictate that single-use and disposal of these products is the best way to ensure patient safety. Patient safety is our primary focus – not cost savings, time savings, or any other factor

In some operating rooms, the usual practice is to reuse disposable syringes while changing needles. This practice is based on the assumption, that since only needles enter the injection site, it is the only part that can be contaminated. A high proportion of reused syringes were contaminated even if only the needle had contact with blood. The probable mechanism of contamination is by aspiration into the syringe of blood remaining in the needle because of the negative pressure generated while removing the needle.

In view of these finding the authors emphasized that “changing needles alone is a useless procedure to prevent contamination.”